	<div class="row">
	    <div class="col-xs-12">
	        <div class="box">
	            <div class="box-header">
	                <h3 class="box-title">Detail Klaim</h3>
	            </div><!-- /.box-header -->
	            <div class="box-body table-responsive">
						<?php
							if(!empty($list)){
						?>
					<table class="table table-borderless table-condensed">
							<tr>
								<th width="15%">Kode Klaim</th>
								<td width="35%">: <?=$list['kd_klaim']?></td>
								<th width="15%">Jenis Kunjungan</th>
								<td width="35%">: <?=$list['jenis_kunjungan']?></td>
							</tr>
							<tr>
								<th width="15%">No.Register</th>
								<td width="35%">: <?=$list['peserta']?></td>
								<th width="15%">Tanggal Masuk</th>
								<td width="35%">: <?=tgl($list['tgl_masuk'])?></td>
							</tr>
							<tr>
								<th width="15%">Nama</th>
								<td width="35%">: <?=$list['nama']?></td>
								<th width="15%">Tanggal Keluar</th>
								<td width="35%">: <?=tgl($list['tgl_keluar'])?></td>
							</tr>
							<tr>
								<th width="15%">Jenis Kelamin</th>
								<td width="35%">: 
								<?php if($list['jk']=="L"){
									echo "Laki-laki";
									}else{
										echo "Perempuan";
									}
										?>
								</td>
								<th width="15%">LOS</th>
								<td width="35%">: <?=$list['lama']." Hari"?></td>
							</tr>
							<tr>
								<th width="15%">Tempat, Tanggal Lahir</th>
								<td width="35%">: <?=$list['tempat_lahir'].", ".tgl_saja($list['tgl_lahir'])?></td>
								<th width="15%">Diagnosa Awal</th>
								<td width="35%">: <?=$list['diagnosa_lain']?></td>
							</tr>
							<tr>
								<th width="15%">Unit</th>
								<td width="35%">: <?=$list['unit'] ?></td>
								<th width="15%">Dokter</th>
								<td width="35%">: <?=$list['dokter']?></td>
							</tr>
							<tr>
								<th width="15%">No. DMK</th>
								<td width="35%">: <?=$list['dmk']?></td>
							</tr>
					</table>
	                <div class="clearfix" style="margin-top:20px;"></div>
	                <h4>Diagnosa Akhir</h4>
	                <table class="table table-striped table-bordered table-hover table-condensed">
	                	<thead>
							<tr>
								<th width="1.5%">#</th>			
								<th width="25%">Diagnosa</th>	
							</tr>
						</thead>
							<?php
						if ($jumlah2>0) {
							$no=1;
							foreach ($diagnosa_klaim as $value) { ?>
							<tr id="div_<?= $value['id_klaim_diagnosa'] ?>">
								<td><?= $no; ?></td>
								<td><?= $value['diagnosa'] ?></td>
							</tr>
							<?php
							$no++; 
							} ?>
							<?php }else{ ?>
								<tr><td colspan="5" align="center">Tidak ada data</td></tr>
							<?php } ?>
	                </table>
					<div class="clearfix" style="margin-top:20px;"></div>
					<h4>Layanan</h4>
	                <table class="table table-striped table-bordered table-hover table-condensed">
	                	<thead>
							<tr>
								<th width="5%">#</th>			
								<th width="25%">Layanan</th>			
								<th width="15%">Tarif Perda</th>			
								<th width="5%">Jumlah</th>			
								<th width="15%">Tarif Diminta</th>			
								<th width="18%">Sub Total</th>			
							</tr>
						</thead>
							<?php
						if ($jumlah1>0) {
							$total=0;
							$no=1;
							foreach ($layanan_klaim as $value) { 
							$subtotal = $value['tarif_diminta']*$value['frekuensi_diminta'];?>
							<tr id="div_<?= $value['id_klaim_layanan'] ?>">
								<td><?= $no; ?></td>
								<td><?= $value['layanan'] ?></td>
								<td><?= formatRupiahTabel($value['tarif_perda']) ?></td>
								<td align="center"><?= $value['frekuensi_diminta'] ?></td>
								<td><?= formatRupiahTabel($value['tarif_diminta']) ?></td>
								<td><?= formatRupiahTabel($subtotal) ?></td>
							</tr>
							<?php 
							$total=$total+$subtotal;
							$no++;
							} ?>
							<tr>
								<td align="right" colspan="5"><b>Total</b></td>
								<td><b><?=formatRupiahTabel($total)?></b></td>
							</tr>
							<?php }else{ ?>
								<tr><td colspan="7" align="center">Tidak ada data</td></tr>
							<?php } ?>
	                </table>
	                <?php 
	                foreach ($penunjang as $value) { ?>
	                	<div class="clearfix" style="margin-top:20px;"></div>
	                	<h4><?= $value['kategori_penunjang']?></h4>
		                <table class="table table-striped table-bordered table-hover table-condensed">
							<thead>
								<tr>
									<th width="5%">#</th>			
									<th width="25%">Penunjang</th>			
									<th width="15%">Tarif Perda</th>			
									<th width="5%">Jumlah</th>			
									<th width="15%">Tarif Diminta</th>			
									<th width="18%">Sub Total</th>			
								</tr>
							</thead>
								<?php
							if ($jumlahp[$value['id_kategori_penunjang']]>0) {
								$total=0;
								$no=1;
								foreach ($penunjang_klaim[$value['id_kategori_penunjang']] as $value) { 
								$subtotal = $value['tarif_diminta']*$value['frekuensi_diminta'];?>
								<tr id="divp_<?= $value['id_klaim_penunjang'] ?>">
									<td><?= $no;?></td>
									<td><?= $value['penunjang'] ?></td>
									<td><?= formatRupiahTabel($value['tarif_perda']) ?></td>
									<td align="center"><?= $value['frekuensi_diminta'] ?></td>
									<td><?= formatRupiahTabel($value['tarif_diminta']) ?></td>
									<td><?= formatRupiahTabel($subtotal) ?></td>
								</tr>
								<?php 
								$total=$total+$subtotal;
								$no++;
								} ?>
								<tr>
									<td align="right" colspan="5"><b>Total</b></td>
									<td><b><?=formatRupiahTabel($total)?></b></td>
								</tr>
								<?php }else{ ?>
									<tr><td colspan="7" align="center">Tidak ada data</td></tr>
								<?php } ?>
						</table>
	                <?php
	                }
	                ?>
					
						<?php 
							}else{
						?>

	                <table class="table table-striped table-bordered table-hover table-condensed">
							<tr><td colspan="2" align="center">Tidak ada data</td></tr>
					</table>
						<?php 
							}
						?>
					</table>									
	            </div><!-- /.box-body -->
	        </div><!-- /.box -->                            
	    </div>
	</div>